{"id":4279,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/pagetsdiseaseofbone\/"},"modified":"2023-09-26T14:27:05","modified_gmt":"2023-09-26T13:27:05","slug":"pagetsdiseaseofbone","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rheumatology-2\/pagetsdiseaseofbone\/","title":{"rendered":"Paget&#8217;s Disease of Bone"},"content":{"rendered":"\n<title>Pagets Disease of Bone<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">History<\/h4>\n\n\n\n<p>Patients may present with a variety of symptoms including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bone pain &nbsp;<\/li>\n\n\n\n<li>Bone deformity <\/li>\n\n\n\n<li>Pathological fracture<\/li>\n\n\n\n<li>Deafness<\/li>\n\n\n\n<li>Osteoarthritis<\/li>\n\n\n\n<li>Incidental finding<\/li>\n<\/ul>\n\n\n\n<p><strong>Examination<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Most patients have no abnormalities<\/li>\n\n\n\n<li>Where there is bone deformity, this usually affects &nbsp;tibia, skull or femur<\/li>\n<\/ul>\n\n\n\n<p><strong>Investigations<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Routine biochemistry (raised ALP, with otherwise normal LFT, calcium and U&amp;E) <\/li>\n<\/ul>\n\n\n\n<p>X-ray pelvis and lumbar spine ( abnormal in 70% of patients)<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">When to refer<\/h4>\n\n\n\n<p>Patients suspected to have Paget\u2019s should be referred for evaluation to determine if antiresorptive treatment is indicated<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Initial management<\/h4>\n\n\n\n<p>Treat on a symptomatic basis pending clinic review.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a rel=\"noreferrer noopener\" href=\"https:\/\/www.versusarthritis.org\/about-arthritis\/conditions\/pagets-disease-of-bone\/\" target=\"_blank\">Pagets-disease of bone<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.paget.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.paget.org.uk<\/a><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Pagets Disease of Bone History Patients may present with a variety of symptoms including: Examination Investigations X-ray pelvis and lumbar spine ( abnormal in 70% of patients)<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4395,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[625],"class_list":["post-4279","page","type-page","status-publish","hentry","category-pagets-disease-of-bone"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/rheumatology\/pagets-disease-of-bone\/\" rel=\"tag\">Paget's Disease of Bone<\/a>","rttpg_excerpt":"Pagets Disease of Bone History Patients may present with a variety of symptoms including: Examination Investigations X-ray pelvis and lumbar spine ( abnormal in 70% of patients)","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4279","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4279"}],"version-history":[{"count":4,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4279\/revisions"}],"predecessor-version":[{"id":16769,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4279\/revisions\/16769"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4395"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4279"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4279"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}